Medical connector and method for nasally administering or removing a substance

ABSTRACT

A medical connector contains a plurality of arms having respective entrance ports. The medical connector also contains a cover preferably having first and second caps coupled together by a first tether, and a fastener coupled to at least one of the first and second caps by a second tether. The fastener is secured to a portion of the medical connector. The first and second caps are adapted to cover at least a portion of the entrance ports of respective first and second arms of the plurality of arms. The medical connector preferably has a sleeve that is detachably coupled to a first arm of the plurality of arms. The first cap preferably comprises a first portion with a first inner diameter adapted to encircle an end of the first arm and a second portion with a second inner diameter adapted to encircle a distal end of the sleeve.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention is directed to medical connectors, and morespecifically, to a medical connector for nasally administering orremoving a substance from a patient's stomach.

2. Description of the Related Art

When a patient cannot receive medication and food orally, a nasalgastric tube may be employed for introducing medication and food intothe stomach. Nasal gastric tubes may also be used for withdrawingsubstances from a patient's stomach. Such tubes comprise a flexibleplastic material which comes in various diameters depending upon thesize of the patient and the nature of the substance to be passed throughthe tube. The tube is fed through the patient's nose, down the esophagusand into the patient's stomach, while taking care not to insert the tubeinto the patient's lungs. A portion of the tube extends out of thepatient's nostril and terminates at a point remote therefrom.

U.S. Pat. No. 4,895,562 to Lopez, which is incorporated herein byreference, discloses a medical connector for attachment to the end of anasal gastric tube. The medical connector comprises three passagewayshaving entrance and exit ports. A stop-cock type valve is disposed atthe convergence of the passageways such that different combinations ofthe passageways may be connected in fluid communication. Various typesof medical devices may be attached to the medical connector, such assyringes, syringe pumps, and/or collection bags, for administering orremoving substances to or from the patient's stomach.

For example, in one embodiment disclosed in the '562 patent, the firstpassageway is in fluid communication with a syringe pump foradministering or removing a substance to or from the patient's stomach,the second passageway is in fluid communication with a syringe forapplying medication, and the third passageway is in fluid communicationwith the nasal gastric tube. In a first valve position, the second andthird passageways are in fluid communication so as to allow the flow ofsubstances into the patient. The syringe connected to the secondpassageway may contain medication or wash-out fluid for cleaning toxiccontaminants from the patient's stomach. In a second position, thepassageway to the syringe is blocked and the first and third passagewaysare in fluid communication so that food may be pumped into the patientor substances may be pumped from the patient's stomach.

In the course of such medical procedures, one or more of the componentsof the stomach-pumping system may be temporarily detached. During theseperiods of detachment, there is a risk of contamination of the medicalconnector from outside sources and/or a risk that the contents of theconnector may drip out and contaminate other devices or persons. Apatient undergoing nasal administration of food or medication may beespecially susceptible to infection, and care must be taken to maintaindevices in contact with the patient as sterile as possible. Moreover,substances that must be removed from a patient's stomach generally haveinherently dangerous chemical or biological properties and could causeharm to others after they are withdrawn. Thus, there is a need for amedical connector in a stomach-pumping system with openings that can beconveniently and repeatedly sealed off during periods of detachment fromother components.

SUMMARY OF THE INVENTION

One aspect of the present invention involves a medical connectorcomprising a plurality of arms and a cover. Each of the plurality ofarms preferably has an entrance port coupled to a passageway. Thepassageways preferably converge at a valve. The valve may comprise aface with markings to indicate which of the passageways are in fluidcommunication. The markings are preferably black. The cover preferablycomprises first and second caps, first and second tethers, and afastener. The first and second caps are preferably coupled together bythe first tether. The second tether and the fastener preferably couplethe cover to the medical connector.

The first cap is adapted to cover at least a portion of the entranceport of the first arm and the second cap is adapted to cover at least aportion of the entrance port of the second arm. At least one of the capspreferably comprises a first portion with a first inner diameter adaptedto encircle an end of an arm of the medical connector and a secondportion with a second inner diameter adapted to encircle a region on thearm adjacent to the end. Alternatively, a sleeve may be coupled to theend of an arm and the cap may be configured to cover an open end of thesleeve.

A method of using the medical connector preferably comprises: (1)inserting a tube through a nostril of a patient; (2) coupling a medicalconnector, made in accordance with an embodiment of the invention, tothe tube; (3) removing the first and/or second caps from the first andsecond arms; (4) connecting a first medical device to the first armand/or a second medical device to the second arm; (5) adjusting a valveof the medical connector so as to allow a substance to flow between thestomach and the first medical device; and (6) disconnecting either orboth medical devices and re-attaching one or both caps to the arms ofthe medical connector.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing features, aspects, and advantages of the present inventionwill now be described with reference to the drawings of preferredembodiments that are intended to illustrate and not to limit theinvention.

FIG. 1 is a schematic illustration of a medical connector according toan embodiment of the present invention wherein an arm of the connectoris attached to a tube having one end disposed inside a patient'sstomach.

FIG. 2 is an enlarged schematic illustration of a medical connector ofFIG. 1.

FIG. 3 is a schematic illustration of an embodiment of a medicalconnector according to the present invention including a sleeve.

FIG. 4 is a cross-section view of the medical connector in FIG. 2wherein the valve and the cover are not shown.

FIG. 5 is a side view of an alternative embodiment of a cover inaccordance with the present invention.

FIG. 6 is a top view of the cover shown in FIG. 5.

FIG. 7 is a magnified top view of a cap shown in FIG. 6.

FIG. 8 is a cross-sectional view of a tether of the cover of FIG. 6along the line 8—8.

FIG. 9 is a schematic illustration of a medical connector according toan embodiment of the present invention with one of two caps removed fromits respective arm.

FIG. 10 is a perspective view of an embodiment of a medical connectoraccording to the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The following detailed description of preferred embodiments refers tothe attached figures; however, the invention is not limited to anyparticular embodiment(s) disclosed herein. The scope of the presentinvention is intended to be defined only by reference to the appendedclaims.

In certain embodiments, such as that schematically illustrated in FIGS.1–4, a medical connector 10 comprises a plurality of arms (e.g., a firstarm 15, a second arm 20, and a third arm 25) and a cover 30. Theplurality of arms 15, 20, 25 each has corresponding entrance ports 40,45, 50 (FIG. 2) coupled to corresponding passageways 70, 75, 80 (FIG.4).

The cover 30 preferably comprises a first cap 90, a second cap 95, afirst tether 100, a second tether 105, and a fastener 110. The first cap90 and second cap 95 are preferably coupled together by the first tether100. The fastener 110 is secured to a portion of the medical connector10 and coupled to at least one of the first and second caps 90, 95,preferably by a second tether 105. The first cap 90 is adapted to coverat least a portion, and preferably all, of the first entrance port 40 ofthe first arm 15 and the second cap 95 is adapted to cover at least aportion, and preferably all, of the second entrance port 45 of thesecond arm 20.

As used herein, the term “entrance port”, when applied to the arms 15,20, 25 of the medical connector 10, means the opening at the end of eacharm in communication with the environment. The entrance port of an armis generally where a tube, syringe, or other component external to themedical connector 10 may be placed in fluid communication with theconnector 10. The term “entrance port” does not imply that a substancemust flow through the medical connector 10 in a specific direction.

As shown in FIG. 2, at least one of the plurality of arms 15, 20, 25preferably comprises a series of different sized tapered flanges 120that are adapted to receive tubes of different diameters. The flanges120 near the entrance ports 40, 50 have a smaller diameter, while theflanges 120 further from the entrance ports 40, 50 have a largerdiameter, and the flanges in between increase in diameter incrementallyfrom each end. The flanges of increasing diameter facilitate creating asecure interference fit between an end of an arm and another componentsuch as a tube.

In certain embodiments, at least one of the plurality of passageways 70,75, 80 is tapered. For instance, in the illustrated embodiment of FIG.4, the second arm 20 is configured such that the passageway 75 has aninwardly tapering sidewall 123 that approximately matches the taper ofthe luer of a syringe. The inwardly tapering sidewall 123 is adaptedsuch that the luer fits snugly within the passageway 75. In otherembodiments, the inwardly tapering sidewall 123 may be adapted toreceive and secure a mating fitting of a syringe pump. In yet otherembodiments, the second arm 20 may be configured to provide a secureconnection with a medical implement, such as a syringe, using a luerlock. In such an embodiment, the end of the second arm 20 preferablyincludes threads, rabbit ends, or any other suitable securing means. Thedescription of such fittings and connections on the second arm 20 isexemplary and it will be appreciated that one or more of the other arms15, 25 may include any one of a variety of such fittings and/orconnections.

Although the medical connector 10 illustrated in FIGS. 1–4 comprisesthree arms 15, 20, 25, other embodiments may have more or fewer arms.The cover 30 may be configured, as necessary, with fewer or additionalcaps similar to the first and second caps 90, 95, and fewer oradditional tethers for preferably coupling the caps together into asingle cover 30.

As illustrated in FIG. 3, the medical connector 10 may further comprisea sleeve 160 detachably coupled to the first arm 15. The sleeve 160 hasa proximal end 164 and a distal end 165, and may be constructed to be auniversal adapter for receiving tubes of different diameters. Forexample, the inside of the sleeve 160 may be fabricated of a resilientmaterial, such as a silicon rubber, that expands to accommodate cannulasof varying diameters on medical devices such as syringes or syringepumps. The inner diameter of the sleeve 160 may comprise one or moretaper profiles that increase the range of tube diameters that may bereceived and securely held by the sleeve 160.

The length of the sleeve 160 is selected to achieve certain designobjectives. If the sleeve 160 is too long, the distal end 165 of thesleeve 160 may interfere with medical procedures in which the medicalconnector 10 is used or may cause discomfort to the patient. Preferably,the length of the sleeve 160 is between about ½ inches and about 3inches, even more preferably between about 1 inch and about 2½, and mostpreferably about 1½ inches; however, sleeves having lengths outsidethese ranges are also consistent with embodiments of the medicalconnector 10 and the cover 30.

Referring to FIGS. 5–8, the cover 30 preferably comprises first andsecond caps 90, 95, which are preferably coupled together by the firsttether 100. The first cap 90 is adapted to cover at least a portion of afirst arm 15 and the second cap is adapted to cover at least a portionof the second arm 20. Fastener 110 is preferably coupled to at least oneof the first and/or second caps 90, 95, or the first tether 100 by thesecond tether 105.

In certain embodiments, the first cap 90 may be used to cover either thedistal end 165 of the sleeve 160 (FIG. 3) or the end of the arm 15 whenthe sleeve 160 is not attached to the first arm 15 (FIG. 2).

As illustrated in FIG. 7, the first cap 90 preferably comprises a firstportion characterized by a first inner diameter d_(small) that isadapted to encircle an end of the first arm 15 and a second portion witha second inner diameter d_(large) that is adapted to encircle the distalend 155 of the sleeve 160. The smaller-diameter portion is preferably atthe end of the cap (see, e.g., FIG. 2), and forms a dome-like structureabove the larger-diameter portion.

The use of a cap having two diameters d_(small), d_(large) offers manyadvantages. For example, it allows a single cap, such as the cap 90, tobe used whether or not a larger-diameter sleeve 160 is attached to thefirst arm 15. It obviates the need of providing a separate, third cap orsome other means to cover the sleeve 160. The two diameters of the firstcap 90 also allow a single cap to fit multiple arms of the medicalconnector 10 having different diameters. The cover 30 could comprise asingle cap 90 that fits both the first arm 15 (using the diameterd_(small)) and the second arm 20 (using the diameter d_(large)).Alternatively, the cover 30 depicted in FIGS. 5 and 6 could be used on amedical connector 10 having more than three arms. The cap also may beconfigured with three or more sections of different diameters toaccommodate an even wider range of diameters of arms and/or sleeves.

The second cap 95 may be configured similarly to the first cap 90, suchthat the second cap 95 has portions characterized by a smaller diameterand a larger diameter. Alternatively, the first and/or second diametersof the second cap 95, may be different from those used for the first cap90.

In other embodiments, the cover 30 may comprise a single cap 90 havingtwo diameters d_(small), d_(large). In such embodiments, the cap 90 maybe constructed so that it is not tethered to the medical connector 10,in which case it may be placed or stored in an appropriate location whenthe first cap 90 is removed from the medical connector 10.Alternatively, the cover 30 may comprise a single cap 90, a fastener110, and a tether 100 for coupling the cap 90 and the fastener 110together. The fastener is coupled to a portion, preferably an arm, of amedical connector. Whether or not the single cap 90 is attached to afastener 110, the smaller diameter of the cap 90 may be used to coverthe end of an arm of the medical connector 10 and the larger diametermay be used to cover the end of a different arm of the medical connector10 or a sleeve 160, if attached.

Two or more covers may also be applied to a single medical connector 10,each cover having one or more caps for covering the ports on differentarms of the medical connector 10. One or more of the covers mayoptionally comprise its own fastener, such as the fastener 110, forsecuring the covers to the medical connector 10. Alternatively, a singlefastener 110 may be couple to a plurality of tethers that are connectedto each of the caps used on the medical connector 10.

The caps 90, 95 of the cover 30 may be used to cover the entrance ports40, 45 prior to use of the medical connector 10 and during periods whenthe first and second arms 15, 20 are disconnected from medical devices.The caps 90, 95 are preferably made of a flexible material, such as amedically inert plastic, and thus stretch during attachment to the arms15, 20, providing a tight seal around the entrance ports 40, 45.Alternatively, the first cap 90, the second cap 95, or both may be madeof a rigid material such as a hard plastic or metal. In this case, thecaps 90, 95 are preferably constructed so as to snap or screw onto theends of the first and second arms 15, 20, to form a tight seal aroundthe entrance ports 40, 45.

In certain embodiments, only the first cap 90 is tightly secured to thearm 15, while the second cap 95 more loosely surrounds the end of thesecond arm 20. In such embodiments, the first tether is stretched duringattachment of the first cap 90 and the tension of the tether holds thesecond cap 95 in place over the end of the second arm 20. When the firstcap 90 is removed from the first arm 15, the second cap is easilyremoved, allowing both entrance ports 40, 45 to be quickly uncovered andmade available for use.

The second tether 105 is preferably affixed to an edge 125 of the secondcap 95 such that the second cap 95 and the second tether 105 aredisposed in a substantially common plane on a bottom side 130 of thecover 30 when the cover 30 is laid flat. Other attachment locations andorientations of the second tether 105 may also be used. For instance,the second tether 105 may be secured to the first cap 90, or to thefirst tether 100, or to a different location. The second tether 105 mayalternatively be secured at a different angle or to a different portionof the cap to facilitate attachment to the arms.

The primary advantage of the tethers 100, 105 is to keep the first andsecond caps 90, 95 in proximity to their respective first and secondarms 15, 20 when the caps are not covering the entrance ports 40, 45(for example, when they are removed so that medical devices may beconnected to the arms). This keeps the caps 90, 95 from being lost orcontaminated, or from releasing contaminated material. By keeping thecaps 90, 95 in close proximity to the medical connector 10, the caps 90,95 are also readily available to quickly cover the entrance ports 40,45, to prevent backwash and contamination problems when the medicaldevices are removed. The tethers also permit one-handed opening orclosing of the passages. Caps without tethers would require one hand forholding the medical connector 10 and another hand to remove, orre-attached, and hold the cap. Medical practitioners are often requiredto hold multiple implements during medical procedures and the one-handedattachment and removal of the caps is therefore a significant advantage.

When the first cap 90 is disconnected, it may be desirable in certaincases that the first cap 90 remains particularly close to medical valve10. This natural disposition of the first cap 90 closer to the entranceport 40 helps to prevent the cover 30 from interfering with medicalprocedures preformed and also reduces the amount of annoyanceexperienced by the patient from the cap 90 dangling farther from themedical connector 10.

FIG. 9 illustrates one embodiment of the cover 30 wherein the first cap90 remains relatively near the medical valve 10. In such an embodiment,at least one of the first and second tethers 100, 105 is structured sothat first cap 90 is disposed close to a center line CL passing throughthe center of the first arm 15 when the first cap 90 is removed from thefirst arm 15.

FIG. 8 illustrates one configuration of the first and second tethers100, 105 for providing such a natural disposition of the first cap 90,wherein at least one of the first and second tethers 100, 105 has asubstantially unshaped cross-section. The u-shaped cross-section of thetethers 100, 105 creates a biasing condition in which the tether has anatural tendency to bend inwardly toward the entrance port 40.

Preferably, the fastener 110 is secured to one of the plurality of arms15, 20, 25. As shown in the illustrated embodiment of FIG. 2, thefastener 110 is secured to the third arm 25; however, the fastener 110may alternatively be secured to another arm of the medical connector 10,such as the second arm 20, or to some other portion of the medicalconnector 10.

As illustrated in FIG. 6, the fastener 110 preferably comprises a ring140 with an inner diameter d. The arm to which the fastener 110 attachesmay comprise a body portion 145 and a neck portion 150, wherein the neckportion 150 has an outer diameter d_(attach) (see FIG. 4). In certainembodiments, the inner diameter d of the fastener 110 is substantiallyequal to the neck diameter d_(attach). In other embodiments, the innerdiameter d of the ring 140 is larger than the diameter d_(attach)allowing the cover 30 to freely rotate about and slide along the neckportion 150. For example, in one embodiment the neck portion 150 has adiameter d_(attach) that is approximately ¼ inch and the inner diameterd is approximately 1/32 to 1/16 inch larger that the diameterd_(attach).

The fastener 110 may also comprise a resilient material, and the innerdiameter d of the fastener 110 may, prior to attachment of the fastener110, be less than the neck diameter d_(attach). In such an embodiment,the ring 140 is pressed or stretched over one of the plurality of arms15, 20, 25.

A fastener may alternatively comprise a void that is non-circular and,therefore, is not characterized by a single diameter d. For instance,the void may comprise a hexagonal or octagonal shape that has favorablemanufacturing characteristics. If the medical connector and one or moreof the tethers are integrally formed, the fastener(s) would constitutethe juncture(s) between such tether(s) and the body of the medicalconnector.

For simplicity during fabrication, in certain embodiments, the first andsecond tethers 100, 105, the first and second caps 90, 95, and fastener110 may be integrally formed using a common mold. In other embodiments,one or more of these components of the cover 30 are separatelyconstructed and then attached to the remaining components. For example,the fastener 110 may be made separately from the other components of thecover 30 and from a more durable material. If the fastener 110 is madefrom a more durable material, it will accommodate a higher stressloading during use of the medical connector 10. The rest of thecomponents of the cover 30, which might experience less stress duringuse, could be made of a material having other desirable characteristics,such as lower cost or greater elasticity.

Referring to FIG. 10, the medical connector 10 preferably comprises avalve 170 that is adapted to selectively connect two or more of theplurality of passageways 70, 75, 80 of the arms 15, 20, 25. The valve170 may have a handle 175 that is rotated to different positions toconnect the various passageways 70, 75, 80. In certain embodiments, thehandle 175 comprises a face 180 with markings 185 that are adapted toindicate which of the passageways 70, 75, 80 are in fluid communication.The markings 185 preferably comprise a set of three arrow and the word“OFF”.

Preferably, the face 180 has a surface that is white and diffuses light,so as to provide a contrast to the markings 185. In one embodiment, themarkings 185 are red in color. In a preferred embodiment, the markings185 are black in color. The use of black markings is believed to providebetter wear characteristics in connection with the visibility of themarkings 185 after prolonged periods of use of the medical connector 10.In yet other embodiments, the markings 185 may comprise a phosphorescentpaint that is visible under low lighting conditions.

Before use, the medical connector 10 is preferably prepackaged inside asealed, sterile container with the first and second caps 90, 95 attachedto the first and second arms 15, 20 so as to cover the first and secondentrance ports 40, 45. Once removed from the container, the medicalconnector 10 may be attached to tube 115 as illustrated in FIG. 1, thatis with the caps 90, 95 still attached to the first and second arms 15,20. The tube 115 may be made of a resilient material, such as Tygon® andthe first arm 15 may comprise a series of different-sized taperedflanges 120 to aid in attaching the tube 115.

One method of using the medical connector 10 comprises the steps of:removing the first and second caps 90, 95 from the first and second arms15, 20; connecting a first medical device to the first arm and/or asecond medical device to the second arm; adjusting the valve 170 so asto allow a substance to flow between the stomach and the first medicaldevice; and disconnecting either or both medical devices and attachingone or both caps 90, 95 to the arms 15, 20 of the medical connector 10.

If only one medical devices is attached to the medical connector 10, themedical practitioner need only remove one of the caps 90, 95. Theremaining cap may be removed at a later time, as necessary, when thesecond medical device is ready for attachment to the medical connector10.

At least one of the caps 90, 95 preferably comprises a tab 102. The tabmay be disposed, for example, on the side of the cap opposite from thepoint of connection to the tether 100. The tab 102 is used as an aid inremoving the first and second caps 90, 95. The tab 102 is preferablypushed away from the medical connector 10 with the thumb, whilesimultaneously gripping the medical connector with the same hand. Incertain embodiments, the u-shape of the first tether 100 or some othermeans causes the first cap 90 to remain relatively close to the firstentrance port 40. Once the first cap 90 is removed from the first arm15, the cap 90 may be positioned as necessary to allow a medical deviceto be attached to the medical connector 10. The second cap 95 maysubsequently be removed by pulling on the cap 90 and/or the first tether100. If the first and second tethers 100, 105 are made of a resilientmaterial, the second cap 95 can alternatively be removed prior toremoving the first cap 90 by gripping and pulling the second cap 95 awayfrom the medical connector 10. This causes the first and second tethers100, 105 to be stretched until the second cap 95 is pulled over the endof the second arm 20.

A first medical device is connected to the first arm and/or a secondmedical device is connected to the second arm after the selected caps90, 95 have been removed. Various types of medical devices may beattached to the first and second arms 15, 20. For instance, the secondarm 20 may be connected first to a syringe containing a medication or acleansing solution for injection into the stomach through the tube 115.Once the medication and/or cleansing fluid has been so injected, thesyringe may be removed from the second arm 20 and replaced with asyringe pump to withdraw the content of the patient's stomach, includingthe medication and/or cleansing fluid. After the substance in thestomach is removed using the syringe pump, the handle 175 of the valve170 may be rotated approximately 90 degrees counterclockwise from theposition shown in FIG. 10, so as to put the passages 70, 75 in fluidcommunication. The syringe pump may then be used to transfer thesubstance from the syringe pump into a container attached to the firstarm 15. Once the substance is transferred the container, the containermay be detached from the medical valve and the substance removed. Thefirst arm 15 may be connected to a container such as an expandable bagfor receiving a substance from the stomach that may be injected usingthe syringe pump attached to the second arm 20.

In one embodiment, the step of adjusting the valve 170 comprisesrotating the handle 175 to one or more positions so as to allow aplurality of the passages 70, 75, 80 to be in fluid communication. Thevalve 170 interconnects the passageways 70, 75, 80 depending upon whichof the arms 15, 20, 25 are aligned to the arrowheads on the face 180 ofthe valve 170. When the word “OFF” is aligned to one of the arms 15, 20,25, the passageway corresponding to that arm is turned off and isisolated from the passageways of the remaining arms.

For example, in the illustrative embodiment shown in FIG. 10, the word“OFF” is aligned to the second arm 20 and two of the arrows are alignedto the first and third arms 15, 25. In this orientation of the valve170, the first and third passageways 70, 80 (see FIG. 4) of the firstand third arms 15, 25 are in fluid communication and the secondpassageway 75 of the second arm 20 is isolated. Thus, substances such asmedication, cleansing fluid, or contents of the stomach of a patient mayflow between the tubes connected to the first and third arms 15, 25.

If the valve 170 is rotated 90 degrees clockwise from the position shownin FIG. 10, as viewed from the front face 180, the first passageway 70of the first arm 15 is turned off and the second and third passageways75, 80 of the second and third arms 20, 25 are in fluid communication.Conversely, if the valve 170 is rotated 90 degrees counterclockwise fromthe position shown in FIG. 10, as viewed from the front face 180, thethird passageway 80 of the third arm 25 is turned off and the first andsecond passageways 70, 75 of the first and second arms 15, 20 are influid communication. If the valve 170 is rotated 180 degrees from theposition shown in FIG. 10, all three passageways 70, 75, 80 of the threearms 15, 20, 25 are all interconnected and in fluid communication.

In certain embodiments, if the valve 170 is rotated approximately ±45degrees or ±135 degrees from the position shown in FIG. 10, each of thepassageways 70, 75, 80 are isolated and are not in fluid communicationwith any of the other passageways 70, 75, 80. In this position,essentially no fluid or other substance flows through the valve 170.

The method of using the medical connector 10 also preferably comprises astep of disconnecting either or both medical devices sometime during themedical procedure. When a medical device is disconnected, one or bothcaps 90, 95 are re-attached to the arms 15, 20 of the medical connector10. In this way, the passageways 70, 75 of the medical connector 10 areisolated from the environment.

1. A medical connector, comprising: a plurality of arms, each arm havingan entrance port and a passageway; a first cap and a second cap directlycoupled together by a first tether, the first cap adapted to cover anend of a first arm of the plurality of arms to substantially obstructfluid flow therethrough, the second cap being adapted to cover an end ofa second arm of the plurality of arms to substantially obstruct fluidflow therethrough; a fastener secured to a portion of the medicalconnector and coupled to either the first cap or the second cap by asecond tether, wherein the second tether is different than the firsttether and the first cap is further adapted to remain in close proximityto the first arm when the first cap is not engaged with the first armand the second cap is engaged with the second arm; and a valve adaptedto selectively place two or more passageways in fluid communication, thevalve having a face with markings, the markings adapted to indicatewhich of the plurality of passageways are in fluid communication.
 2. Themedical connector of claim 1, wherein the first cap further comprises afirst portion with a first inner diameter adapted to encircle an end ofthe first arm and a second portion with a second inner diameter adaptedto encircle a region near the end of the first arm.
 3. The medicalconnector of claim 2, wherein the second cap further comprises a firstportion with a first inner diameter adapted to encircle an end of thesecond arm and a second portion with a second inner diameter adapted toencircle a region near the end of the second arm.
 4. The medicalconnector of claim 1, wherein the first cap further comprises a tabadapted to facilitate removal or attachment of the first cap to thefirst arm.
 5. The medical connector of claim 1, wherein the fastener issecured to one of the plurality of arms.
 6. The medical connector ofclaim 5, wherein the arm to which the fastener is secured is a thirdarm.
 7. The medical connector of claim 5, wherein: the arm to which thefastener is secured comprises a body portion and a neck portion; thefastener comprises a ring with an inner diameter; and the inner diameteris less than a diameter of the body portion and is substantially equalto a diameter of the neck portion.
 8. The medical connector of claim 1,wherein the markings are black.
 9. The medical connector of claim 1,further comprising a sleeve detachably coupled to the first arm.
 10. Themedical connector of claim 9, wherein the first cap is adapted to covereither the end of the first arm or the end of the sleeve.
 11. A coverfor a medical connector, comprising: a first cap and a second cap, thefirst cap being adapted to cover at least a portion of a first arm of amedical connector to substantially obstruct fluid flow therethrough andthe second cap being adapted to cover at least a portion of a second armof a medical connector to substantially obstruct fluid flowtherethrough, the first and second caps being directly coupled togetherby a first tether; and a second tether different than the first tetheradapted to couple at least one of the first cap or the second cap to aportion of the medical connector.
 12. The cover of claim 11, wherein thefirst cap is adapted to encircle at least a portion of the first arm ofthe medical connector and the second cap is adapted to encircle at leasta portion of the second arm of the medical connector.
 13. The cover ofclaim 11, wherein the first cap further comprises a first portion with afirst inner diameter adapted to encircle an end of the first arm and asecond portion with a second inner diameter adapted to encircle a regionnear the end of the first arm.
 14. The cover of claim 11, wherein atleast one of the caps comprises a flexible material.
 15. The cover ofclaim 11, wherein at least one of the caps comprises a tab.
 16. Thecover of claim 11, wherein at least one of the first tether and thesecond tether has a cross-section that is substantially u-shaped. 17.The cover of claim 1, wherein at least one of the first or second capscomprises a flexible material.
 18. The cover of claim 11, wherein thefirst cap comprises a tab.
 19. The cover of claim 1, wherein the firsttether is longer than the second tether.
 20. The cover of claim 1,wherein at least one of the first and second tethers includes across-section that is substantially u-shaped.
 21. The medical connectorof claim 1, wherein the first cap is adapted to encircle an end of the afirst arm and the second cap is adapted to encircle an end of the secondarm.
 22. The medical connector of claim 1, wherein the fastener, thefirst tether, the first cap, the second tether, and the second cap arepositioned in a substantially linear arrangement.
 23. The medicalconnector of claim 11, wherein the first tether, the first cap, thesecond tether, and the second cap are positioned in a substantiallylinear arrangement.